Cataract with associated lens coloboma, capsular retractors, capsular tension ring (#4) скачать в хорошем качестве

Cataract with associated lens coloboma, capsular retractors, capsular tension ring (#4)

A 47-year-old male was referred to our department due to a progressive, painless decrease in visual acuity in his right eye. He had been monocular since 1997 when his left eye was enucleated following blunt trauma. During the slit-lamp examination, we observed an inferior "coloboma" of the iris and zonular apparatus, as well as a dense nuclear sclerotic cataract. The fundus examination also revealed an inferior retinal coloboma. The decreased vision was largely attributed to the dense cataract, prompting us to proceed with surgery. We did a standard cystotome initiated continuous curvilinear capsulorrhexis. For bag support we decided to use capsular retractors. A mild hydrodissection was performed to facilitate their insertion (although one of them became loose during surgery, it did not pose any issues). The lens was approached using a stop and chop technique, and the epinucleus was carefully managed through viscodissection. Throughout the surgery, we took precautions to continuously tamponade the inferior defect with dispersive OVD, while avoiding anterior chamber collapse. We opted to implant a capsular tension ring (CTR) for long-term bag support, which ensured adequate stabilization. A monofocal single-piece IOL was then injected into the capsular bag. The patient achieved a post-operative best-corrected visual acuity of 20/50. The patient was very satisfied and did not report significant photophobia or other symptoms. It is important to note that a lens "coloboma" is not a true coloboma; rather, it refers to lens contraction or notching resulting from a localized absence of the zonular apparatus. The key to successful surgery lies in providing appropriate support to the bag, whether through a combination of capsular retractors, capsular tension rings, segments, or scleral fixation techniques. With the right technique, favorable outcomes can be achieved. Sorry for the video quality, recorded on an older microscope :) Bookmarks: 00:00 Start 00:03 Dispersive OVD tamponade of the inferior defect, trypan blue staining, main incision, capsulorhexis 00:49 Capsular retractor and hydrodissection 01:21 Phacoemulsification (stop and chop) 02:00 Epinucleus viscodissection and aspiration 03:18 Capsular tension ring insertion 03:48 IOL insertion, viscoelastic aspiration, wound hydration Surgeon: Miguel Raimundo (Centro Hospitalar e Universitário de Coimbra) Background Music: Zelda - Great Fairy Fountain Theme ~ lofi hip hop remix by Rifti Beats    • Zelda - Great Fairy Fountain Theme ~ lofi ...